Extravascular Lung Water as a Target for Intensive Care
Extravascular lung water (EVLW) remains a useful guide for monitoring pulmonary edema (PO) and vascular permeability in sepsis, acute respiratory distress syndrome (ARDS), and heart failure. In addition, EVLW has a prognostic... read more
Critical Care Pearls: Basics for Critical Patient Care and Board Review
Critical Care Pearls for medical professionals involved in taking care of critically ill patients. An excellent resource for board review written by Dr. Iqbal Ratnani and Dr. Salim Surani. Dr. Iqbal Ratnani, MD, FCCP, FCCM... read more
A Non-Antibiotic Approach for Treating or Preventing Sepsis
Researchers at the Royal College of Surgeons in Ireland (RCSI) have tested a compound called cilengitide in a preclinical trial. The drug goes by the brand name InnovoSep. Researchers discover the drug has the potential to... read more
Hospital-acquired Infections – Adding Process Metrics
So far, we've only been looking at metrics that are really big and important. This is certainly a good place to start. To move beyond this, I'd like to introduce the concept of Outcome vs Process Metrics. Outcome Metrics... read more
Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation
In patients presenting to the emergency department with recent-onset, symptomatic atrial fibrillation, a wait-and-see approach was noninferior to early cardioversion in achieving a return to sinus rhythm at 4 weeks. The presence... read more
ICU Survivors Have a Substantial Higher Risk of Developing New Chronic Conditions Compared to a Population-Based Control Group
ICU patients have more chronic conditions during the year before ICU admission compared with a population-based control group and a five times higher odds on developing one or more new chronic conditions compared with the... read more
Evaluating the Need for Pediatric Procedural Sedation Training in Pediatric Critical Care Medicine Fellowship
Pediatric procedural sedation lacks a clearly defined training pathway. Most fellows find pediatric procedural sedation a valuable skill set. We propose that all Pediatric Critical Care Medicine fellows receive training that... read more
Water Resistant and Self-healing Electronic Skin Developed by NUS Engineers
Inspired by underwater invertebrates such as the jelly fish, Assistant Professor Benjamin Tee and his team from NUS Materials Science and Engineering, in collaboration with researchers from Tsinghua University, China and... read more
Telemedicine Reduces ICU Mortality Rate at Valley Health
During the first year of tele-ICU at Valley Health, the technology helped save 125 lives, achieve a 35 to 44 percent reduction in ICU mortality rate, reduce ICU length of stay by 34 percent, reduce the sepsis mortality rate,... read more
Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance
Among patients with E coli or K pneumoniae bloodstream infection and ceftriaxone resistance, definitive treatment with piperacillin-tazobactam compared with meropenem did not result in a noninferior 30-day mortality. These... read more
Management of Pediatric Severe Traumatic Brain Injury
This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects... read more
Psychology Consultation Patterns in a Medical ICU
Intensive care unit (ICU) survivors frequently experience long-lasting mental health, cognitive, and physiologic challenges. Psychologists have a role in providing interventions to reduce patient distress during critical... read more
Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality
Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident cardiovascular disease (CVD) and all-cause mortality in a dose-response manner. 29,615 adults pooled... read more
Trauma Electives in South Africa Provide Valuable Training for International Surgeons
Trauma training and trauma preparedness are increasingly areas of concern worldwide. Formal military conflicts over the past 2 decades have ensured that most military surgeons have been exposed to a significant volume of... read more
3 Tools Doctors Can Use to Prevent Burnout
A broad-based study published in the Mayo Clinic Proceedings in 2015 using the Maslach Burnout Inventory (MBI) found that 54.4 percent of all physicians combined were experiencing at least one symptom of burnout, and there... read more
Acute Hyperglycemic Emergencies
As diabetes prevalence increases in the US, critical care nurses need to be familiar with the acute hyperglycemic emergencies they may encounter in the ED or ICU. This article focuses on the diagnosis of, various treatments... read more
Intrathoracic Pressure Regulation Therapy Applied to Ventilated Patients for Treatment of Compromised Cerebral Perfusion from Brain Injury
These data support the notion that active intrathoracic pressure regulation, in this limited evaluation, can successfully augment cerebral perfusion by lowering intracranial pressure and increasing mean arterial pressure... read more
Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock
In this meta-analysis, the addition of vasopressin to catecholamine vasopressors compared with catecholamines alone was associated with a lower risk of atrial fibrillation. However, findings for secondary outcomes varied.... read more
Lights and Sirens
A true account of going through UCLA's famed Daniel Freeman Paramedic Program—and practicing emergency medicine on the streets of Los Angeles. Nine months of tying tourniquets and pushing new medications, of IVs, chest... read more
Association of ICU Delirium with Sleep Disturbance and Functional Disability After Critical Illness
After adjusting for important covariates, total days of MICU delirium were significantly associated with increased post-discharge sleep disturbance. Delirium incidence showed a trend toward association with increased functional... read more
Mobilization is Feasible in Intensive Care Patients Receiving Vasoactive Therapy
In our ICU, patients mobilized on approximately one-third of vasoactive days. Clinicians should anticipate a higher risk of hypotension during mobilization in patients receiving vasoactive therapy, which may require transient... read more
Time to Add a Fifth Pillar to Bedside Physical Examination
Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number... read more
